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HomeMy WebLinkAbout040-1021-30-100Wisconsin [;apartment of Commerce PRIVATE SEWAGE SYSTEM Safety and building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Marsh, Kimberl Cad ,Town of CST BM Elev: Insp. BM Elev: BM Description: ~+y~ TANK INFORMATION ELEVATION DATA TYPE MANUFACTURE CAPACITY Septic ., - t.' f ~~ Dosing ~~ '' ~, - Holding TANK SETBACK INFORMATION TANK TO P/L ~~~ WELL BLDG. Vent to Air Intake ROAD Septic 7 ~~ ~ f2 ~ i / .~- Dosing E / ~~ / ~~ / Aeration Holding r PUMP/SIPHON INFORMATION ~ ~/ Manufacturer ~ Demand GPM Model Number / 5Z 3~, 3Z TDH Lift// Frictio~Los s System Head3 ~ TDHa g~t i $ ~/• Forcemain Length ` Dia. ~~ Dist. to well / ~ ~ `~ ~/ Z D SOIL ABSORPTION SYSTEM County: St. CrOIX Sanitary Permit No: 515244 0 State Plan ID No: Parcel Tax No: 004-1021-30-100 SectionlTown/Range/Map No: 10.28.15.146A STATION BS HI FS ELEV. Benchmark ~.~ ~~ /~ Alt. BM -~ ~j . ~ /63. ~7 Bldg. Sewer St/Ht Inlet SUHt Outlet ~ ~ Dt Inlet ` ~ Dt Bottom ~ $d ~, ~~, Header/Man. ~ ' /LS/, 7 Dist. Pipe .7. /Z /~ /, Bot. System 7 ~ /~~ y 97 Final Grade BED/TRENCH Width Length / No. Of renc s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS G /~J ~~ ~ '~-~. ~~ ~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: ,~/ /~ /~Q ~ `~ ~ UNIT Model Number: \ DISTRIE3UTION SYSTEM ~ .\ Header/ManifolrY ~/ Distribution x Hole Size I/ x Hole Spacing ~ Ve Air Intake 3 Z Pipe(S' ~ ~ 7.5 ~ 3 in h ' Di S L 3 t ~ 3. ~ Length Dia _ g pac engt a SOIL COVER v Droca~ro Cvc4cmc C)nly YY Mnund Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center J ~ ~ Bed/Trench Edges ~ Topsoil 1 ~ Yes ~ No Yes ;~~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / ~~ / ~~ Inspection #2: / / Location: 3053 50th Ave Wilson, WI 54027 (NW 1/4 NE 1/4 10 T28N R15W) NA Lot 1 ~5~-° ~~ o `.;`y Parcel No: 10.28.15.146A F. ~ ~ o ~-c.._, 1.) Alt BM Description = C ~ ~-1~4~ ,n,s Ply,,,.. ~5 7 1 Rlrtn sawar IPnnth = ~ _/ - , - - - - - ~ ~~ dl/~.. - amount of cover = r Plan revision Required? ~ Yes No ~ / ~ ~^ Use other side for additional information. ~~ ~ _ rG/ Date Insep or's Si ature Cert. No. SBD-6710 (R.3197) ~~i ~ /1 ~ /0 i l ; e:'1 /'a ~ f~ t~il;tiTlt3t'Ce.Wl.ggv Safety and Buildin Division ZOI W. Washingto e 62 ~ C ~p- ~ o C ,~ n~ Madison, 3 ~ Sanitary Permit Number (to be filled in by Co.) /5 2 Sanitary Permit Application State Transaction Number ~~ In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit Note: Application f for state-owned POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you vm e ur ses in accordance with tlme Priva Law, s. 15.04{ 1 m , Stats. ~ L A li r~ cation Information -Please Print All Information ~O S3 Sd dr Property Owner's Narne ~ Parcel # ~/r,'6E' t ~csf/ A{~~ ~ ~ ~Q1a a0'`>~~ ~lSZ/- - /dU Properly Owner's Mailing Address : < ST. CROIX COUNTY ` ~ "'~ .- ' PIANNINO 8 ZONING OF = ~P~Y Location ~ l ~p f 1CE ~O X ~~ . Gavt Lot City, State ~ ' ~V ~ .rt.. > ' Zip Code ~ ~ _ ~~ Phone Number , , ~ /~, NE /., Section ~_ w ER w A t LsJI ~~~.7'.? LS/ 387-,~,?.73 (circle one T 78 N ~ R~# IL Type of Buil~ng (check all that apply) ~~ CFC Lot # , ; oi / I or 2 Family Dwelling -Number of Bedrooms \„Z/ Oa ~ Subdivision Name uSC.. p ~ c- v~- Block # ^ Public/Commercial -Describe Use / ~~~ ^ State Owned -Describe Use CSM Number 0' 2 ~ 8-~+iHag~of ~ ~ ~ ( X /cam s37~ P~ 53 ®Town of t~AD3~ , ~, III. Type of Permit: (Check only one box on line A. Complete tine B if applicable) A_ ,New S stem y '_'°---i P y ^ Re lacement S stem ^ TreatmenUHoldin Tank R lacement Onl g ep Y ^ ONmer Modification to Existin S stem a lain S Y (xP ) B. ^ Pemmit Renewal ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. T e of POWTS S stem/Com nent/Device: (Check all that a 1 u r ^ Non-Pressurized In-Ground ^ Pressurized In-Ground ^ At-Grade Mound > 24 in. of suitable sod ^ Mound < 24 in. of suitable soil ^ Holding Tank ^ Other Dispersal Component (explain} Pretreatment Device (explain) ~~ V. Dis ersaUTreatment Area Information: a , Design Flow (gpd) Design Soi! Application Ra gpdsf) Dispersal Area Require (sf) Dispersal Area Pro (sf) Sy levation 60D /, O Q, ~Ob /50O GOD 17~ ~ /O/,O o./ /ar~.o Go.~rov VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units a ~ ° u = New Tack E k i i T w c ~ ~ u ~ " s x an st ng s Ll~~~n 1~ ~/ ~44~. /~ ~ ~o a U ~ rn y :: am ~~ k, t7 ~ n. Septic or Ileldc /r0 -- Dosing chamber SD - 7 SO ~ /t /~ / VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plaas. Plumber's Name (Print) Plumber's Signature MPS Number Business Phone Number .TON~/ E[.r~ /~ tlz!~.-~ .?~/~5'G 7/S X7.2-S~GG Plumber's Address (Street, City, State, Zip Code) /V G~? 98 fir. /~vr. ,as ~u~c,oNo ~/S SS'7~3t: VIII. Coun /De artment Use Onl ~Appmved Permit Fee Date Issued Issuin gent Signature - 7 ~}~3wn~~~ er Giv eason for Denial $ .oo ~ 2 ~ y Z ~ ~ O IX, Cond easons for Disapproval , ~~~ ~ nn s~~ ~ e~-e~- a;~ • ~ ~ ~ ~ 3 CO''~' `~~ °'^S ''~ r , . pP om/ 1. Se~ic tank, etlltiertt filter and dispersattel(must aU ,be servk:es /maintained ~~~.. • w ~ ~'~ ~,,K; ~,,, as per manage4nent plan prouitied by plumber. 3. All setback requirements must bil,nrlitlt>drtisd ere icable code / ordinaai~s: At[acn to comprete grans for the system and submit to the (:ouoty only on paper not less than 8 12 a 11 inches is size SBD-6398 (R. 02/04) Valid thru 02/11 °~I ..I ^~I 1 ~~ { i i T ~~ ~ ~ ~J - •. ` ti '' a ~' i ~ ti~ ~ a ~ aY °~ ~ v ` ~~ t~ ~ Q . a e ~] ~ ~ v v M ~ ~ ~ ~ V ~ ~~ ~ ~ 1 a V U ~ ~ ~- n ~ ~ 3~ 3 ~~~ -- - ~ M --~ M ~'' 1~ 0 0 a ~~ ~o a ~' ~~ n~ ~~ .~ M ,o d ~~ a M ^e ~o~ \e ~0 ~ v a~ R ~ h ~a~ r ~~ re v ~ r ~ ~ ~. ~ `^ • ° ° 8 I ~ ~ Q o ~ ` ' v ~ Ao O ~ v ~y . ~ \ ~ ~ I ~ ` 'a ~ ~ ~ .x V x ~ ~ ~ v \ a ~ ~ ~ v a ~1 8 ~ Z ~ a ~J ~ ~~ 'v ~J ~~ C~ ~~ ~~ y~ ~e ~~ Q~ 1 I ~~ ~ 1 I . ~ a T ~`n 1 Y ~. H a ~ ~ y ~ .~~ ~ o ~ C 0 oMp v ~ v ~ ~Q ~ ~ ~ v ` ~~ ii ~ Q ~ q ~ ., e v V ~ M ~ ~ ~3 O ~ ~ H ~ ~ ~~ V h ~ Q V V N ' ~ ~ 0 31~ i -- ~ M ~ ~ ~ -- y ~ ~ ~ ~ ~ ~ ~, o b ~ ~~ a o 1` \ O 0 a ~~ ~ 0 1 a ~' ~ ~~ ~~ n~ \~ ~ l_ M O ^~ M ~ 0 0 ~\ 0 v h ,~ ~~ ~ v ~ °e ~0 h r a ~ ~./ b ~ h Q ~a r M C Q t ~ g -. ~ ~ °' \ V I ~ \ Q 0 ~ ~ ~ ~ ' ~ v O ~I ~ ~ ~` ~ ~ ` o ~1o ` L,. lx v k ~ V y ~ ~r a~ M s `~ 2~ ~ v ~t .1 Z 8 ~ ~` ~J i ~ R 1 +~ W J O ~1 ~~ h ~ commerce.wi.gov i ^ ~scons~n Department of Commerce Safety and Buildings 10541N RANCH ROAD HAYWARD WI 54843 Contact Through Relay www. commerce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Richard J. Leinenkugel, Secretary April 13, 2010 CUST ID No. 231346 JOHN HERBERT PELKE PELKE PLUMBING N 6298 ST HWY 25 DURAND WI 54736 CONDITIONAL APPROVAL PLAN APPROVAL EXPII2ES: 04/13/2012 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Identification Numbers Transaction ID No. 1781855 SITE: Site ID No. 755562 Kimberly Marsh Please refer to both identification numbers, 3053 50TH Ave above, in all corres ondence with the a enc . Town of Cady St Croix County Nall/4, NE1/4, S10, T28N, R15W FOR: (;O Description: Mound, 4 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 1261279 r Maintenance required; 600 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; Systems : pE' Mound Component Manual -Version 2.0, SBD-.10691-P (N.O1/O1), Pressure Distribution Component Manual -Versional 2.0, SBD-10706-P (N.O1/O1); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes ' :: SE and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructe and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • Care must be taken to preserve the bench mark during construction. • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. JOHN HERBERT PELKE Page 2 4/13/2010 a -. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. ` • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(1). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. • Insulate building sewer per COMM 82.30(11)(c). • Provide frost protection per COMM 83.43(8)(c). A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, ~ ~-. ~- %~ ~ ~ cia L Shandorf ~" "'° ^- ,;l POWTS Plan Reviewer ,Irate ed Services (715) 634-7810, Fax: (715) b34-5150 , M-th 8:00 -.4:45 "`-° ,.~,,, pat.shandorf@wisconsin.gov ~ w •:~ Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Monday, 7:00 A.M. To 3:30 P.M. Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. "Construction business" means a trade that installs, alters or repairs any building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water amactions code, ch. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture of a building product not on the building site. For further information, go to our website: www.commerce.wi.gov/SB/SB-BuildinaContractorProg_ram.html Note: Effective March 29, 2010, we are consolidating our Shawano full-service office with our Green Bay office. Please address all plans, correspondence, mail, etc. related to previous Shawano services, for delivery after that date, to: Division of Safety & Buildings, 2331 San Luis Place, Green Bay, WI 54304. If calling moved Shawano staff after that date, call (920)492-5601. .: nepertment of Cnmmerae Safety 8~ Buildings Division Bureau of irtfegrated Services APPLICATION FOR REVIEW -Complete all pages- NOTE: Personal information you provide may be used for secondary purposes [Privacy Law s.15.04(1)(m), Stats.] POWTS For plan status, check our website at _ _ _ Several counties have been delegated certain authority to review plans in lieu of Commerce. For a current list of those counties and their delegation dteck our website at httpJ/www.commerce.state.wi.us/SB/S6-PowtsProgram.html. 1. Pmject Information -Fill in all known i nf ormation. Confirmation of assignment to a reviewer. ,, l ProjedlSite Name ~ />NtSE.C [ Y / >A.C Si/ Transaction ID: Location, Number 8 Streei of project (if unknown, indicated nearest road) Previous Related Trans. ID: 3aS3 t9 ~ l1d~ Estimated Completion Date: Legal Description; //// ~t/E /O .18 ii/t /S ~ Assigned Reviewer: County .Sl' LRO/X (-}6ity (-}LtiNege (09 Town of CADY Assigned office: Mail m your office ~ choice below: Green Bay, Hayward, LaCrosse. lAa~son, Shawxro, Waukesha 2. After plans are reviewed, please: (check ail that apply) NOTE: We reserve the right to re-distribute plans to _ Call customer 1.2 (drde number)` another office M needed to reasonaby balance Requesting party wrili pick up turnaround times. Check MtpJ/commerc~wlgov/SB/SB- ~/Mail plans to custome~2 (drde number)• DNDailyDoc.html#Nextfcr office availability and next `Refers to customer number from below review date 3. Complete the following designer/owner/requesting information. llb7ve the check boxes when designer, owner or requesting party is the same to avoid repeating information. Designer Information (Customer 1) Commerce Other please Specify Below (Customer 2) Commerce First Name Last Nam Customer Number ~ ~ Fast Name Last Name Customer Number ov,~ zrzi:cr i'!i-.23/.3f'G ~/~.QE.ccY /`'A.tsH Company Name//~~ /~ Company Name d'E1.rE !/'LNr~lQhJL Address Address N G.? 98 fir, fur. a~ ~O, Qo x /7~ City State Zrp+4 (9digits) ,~..~.t.o.~o, !/I Syy.3t City /J State Zip+4 (~g~) f~/dB~t ~.9zzs. //S syoa.? Phone Number (area code) Fax or Internet cell phone Phone Ntxnber (area code) Fax or Internet cell phone ~iS G7.2-Slc~ 7i G7.?-S.?t7 GS/ 387-.3.73 X66 ,~09- 98i~o Check if applicable Check 'rf appGcal~le or spedfy relationship ( )Owner (X) Owner ( )Other-spedfy relationship 4. rnrvnnanon anv rran ~uomtcrar ~nedutsts. i'vWTS scheduling is not available. Plans wiU be assigned to a reviewer after receipt of plans. If you select a specific office your estimated completion date may be considerabty greater than what would be possible in another office. Submittals received without a specific office indicated on the form may be assigned to offices outer than the receiving office depending on reviewer availability. Submittal cltedclists can be found in each applicable component manual. You may email technical code questions to ComSBPowtsT~~=--~%-~~r~n n<w Madison S86D Hayward S&8D ~~~ Area S~BD Shawano SBBD Green Bay SBBD Waukesha SbBD 201 W Washington Ave 10541N Ranch Rd 3824 N Creekside 7340 E Green Bay 2331 San tuffs Place 141 NW Barstow ~ PO Box 7162 Hayward W154843 Hp~ WI ~~ Shawano WI 54166 Gn:en Bay, Wl 54304 4w Floor Madison WI 53707 7162 715534.4870 (NOTE CHANGE 715524-3626 920.492-5601 War~cesha 1M 53188- 608-266-3151 Fax: 715-634-5150 Fax: 608-283-7444 FAX:920~92-5604 3789 Fax: 608-267-956'6 Email: 608-785-9334 Email: Emalil: PlanSdiedule~ 262-548-8600 TTY: Contact Through PlarsSchedule~ Fax; 608,.785-9330 PlanSd~edule~ twmmerce.state.wi.us Fax: 262-5485614 Relay commerce.state.wi.us commerce.state.wi.us Email: PlanSchedulel3 Email: PlanSct>edule~ t~mtr-erce.state.wi.us commerce.state.wi.us MAKE CHECKS PAYABLE TO DEPT OF COMMERCE I TOTAL AMOUNT DUE Attach check here S80.10ti77 (R.12/OIJZOOS) THIS FORM IS VALID ONLY FROM 1201/2008 _ .ySD. °~° Review Code 7833 FOR THE MOST CURRENT APPLICATION, CHECK OUR WEBSITE AT www.commeroe.state.wi.us/Se/SB-DivFormsIPOVYTS m g W ~~ CEO a~p~ ~ 000 " bN0 0 000 ~- ~~e~~qp~}{pp~~pp l~DyO SOS ~ END OIt~Q~~ 0010q OCWN G N O~ "' f9l9 t9 r ~N~ `C NM1N 7S ~ v~ N~fl1 C S•f/!M fA E 0 o` O > ° ~ ~ °' O . v ~EO. 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O D ~~v ^ ^ x°~o~ a W ~C m v J m m O a .~ ~° h ~S ~~ ~° o~ ~i 3 ~~ o. w~ 0 ~~ ~_+ n ~° eQ '" a e. ~ ~i . / e~ 9 Private On-Site Wastewater Treatment System (POWYS) Index and Title Sheet Owner. /~iir~ ~.c c r /y ~c s,y Project Name and System Type: .~i~ssEit~r~.~sy- y ~•c. /~..,~o l~o~rs Location: 3oss so ~~ ~~E Street Address - Legal Description ' Township/County Contents: ~ Page 1: Page 2: Page 3: - Page 4: ~W.1,S. ztionalry Page 5: ~t-aria _ .y.rr ~~4irP ~id.~i~rot-•c . Citofs • .S~ ri .~ Page 6: 6~~is-o ~6'ilFoR.~si./o! <ii~yr Page 7: 4£ a l"s o .~./rs 's ~.i./sria ~.o./.vs Eirr./r o~../ Page 8: Page 9: » ,. •~ .~ ~~ Attachments: ~o ~ ~ Gw.vsw.~ ro.~ ~£.oi.~ r . _ iii rte.. /`~./>./ rd"w/.~./c~ /./fe Plumber! 1 oy.~ DE~~ Signed: ~-~%~~ Credential Number: /%~- ,7~/3 yG Date: <3 :TS-/o G1S£o SBD -Jot 9/•P~~ ~ uwo ~oyPo.v£•vr /'./avL o !f£itSie,/ .T. D G1 st'A j SQO - /a 70~ -P `',~Arssa~ r ,his rr.oW r..•r Lo.vp~r~~ r /~.iwaA~ " dE,c si..v .7. o r - ~+ y~•. 4 Ft . ds ~ . R.R ~ R R R•-f! ~• . - • • • s ~ •- ~ . - - ' . `v - - - - a- -'- . '~-.~'~' w m , - „.. - a _t _. ~ _ _ o~. o -r ~ .o -~ t - t _ ~ h o - ~- i R ~ a - p i ~ b t - t~ - - s1t- ~ ~ * ~ ~ ~. t n .-.. - ~ ! n ~ !- g '~ _ ~ ~_ ~N - - - _ _ ~ b - w~ - -. - ~ o ~' w ~ ~.: .. o ~ ~ _ ~L \ a • o '- C - ~ ~. ~V ~v Op ~ .1-r~I t~. M• O crrtRRZ • . .. • •• 1= i 1 ~ ~~ ~ ~~~~ .... • \ C o ~ a ~`a~ * ~ `a ~ ~ y 0 x ~ r ~ '~ . p 11 ~ k ~' • ~ ~ i N l ~ n 11 . ` p ~ \~ v ~~ • a k~ ~' . w moo' x y^ ~ !1 .. ~I \ O ~ ~ l\ _ ~ ~ ~ n O q~ co, ~ ~ (a h ,r ~ r b Z ~ 3 ~ o ~ ~ • 1 Z ~ '• r `0 w k o. ~ . . • ~ ~ ' a. • ~• ro o `+ t u ~ y ~ . •. ~~ . F' ~0 o ~. 9 m 0 '~O . .~ Page S Of _9_ • SEPTIC TANK E'PUMP CHAMBER CROSS SECTION'AND SPECIFICATIONS s ~Scw yo. - 4" CI. VENT PIPE 12" MIN. ABOVE GRADE ~ ~IEATNERPROOF ?' /p~ FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH-AIR INTAKE WITH CONDUIT MANHOLE COVERS W/ PADLOCK E f~Nf:,ya-a - WARNING LABEL ~-.,__._~ 4 " MIN . 18" IN. .. ~ ,~~ - ;, ; INLET .. ~~ .WATER TIGHT SEALS _ Zq,6Et - _. .~ GAS- ~ ~ TIGHT ~ ~ ~I _ _ ~ :/~, ,~,Lrra A SEAL ~. APPROVED JOINTS WITH ' APPROVED ~ -- - _ - -'~'` i ; ALM APPROVED PIPE PIPE 3` ~ 8 ~ ~ pN 3` ONTO ~OitTO SOLID ~ ~ . SOLID SOIL SOIL' - PUMP OFF ELEV . ' 9o.G FT. ~ ~ ' OFF ~'~~ RISER EXIT . D PERMITTED ONLY - IF TANK _ ~ MANUFACTURER HAS AFPROVAL ____ 3" APPROVED BEDDING UNDER TANK CONCRETE .PAD . SPECIFICATIONS SEPTIC / DOSE . TANK MANUFACTURER: _ ~,/,~f~-~, ~,~~,~~r~ KJMBER DOSES PER DAY: sy~i~s~~ . • TANK SIZES: .SEPTIC /as-o GAL. ~ ~ DOSE VOLUME INCLUDING ~~0'8 '~ ~'8 DOSE 7so GAL.. - ~ - FLOWBACK: /.t8.8 .GAL. ALARM MANUFACTURER: ` ~ _ ~ST E~~iyo avs CAPACITIES: A = .3o INCHES = f~8.3' GAL. ~ MODEL NUMBER: ~',4.vr LERr..Z~ `-'~ ~'~" SWITCH TYPE: ~~-R~.,~,r ~ _ ~~, ~ ~A~s B = 2 INCHES = 3,~ .? GAL. PUMP MANUFACTURER: - ~DELLE.C ~awv C = 8 INCHES = /•?8.8 GAL. MODEL NUMBER : ,/,s-,~ `~- SWITCH TYPE: /'9E-~tc4,~r D ~ = 8 INCHES ~ /,~8 8 GAL . REQUIRED DISCHARGE RATE 3~3a GPM PUMP E ALARM WIRING A S PER ILHR 16:23 WAC VERTICAL -DIFFERENCE BETWEEN PUMP OFF AND DISTI~IBUTI ON PIPE /~ o FEET + MINIMUM NETWORK SUPPLY PRESSURE ~ 3 FEET + . /~o FEET FORCEMAIN ~~X mss' FT/100 FT. FRYCTION FACTOR ~ FEET . ~ TATAL DYNAMIC HEAD = '/7./ FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH SS ~ ; WIDTH 80~~ ; DIAMETER LIQUID D~FPTH- y8'• D.GaF9 LL PUMP PERFORMANCE CURVE MODEL 151/152/153 1a 0 35 ~ 10 U ~ 6 ~ ° g 20 15 4 10 z s FLOW PER MINUTE CIF"-_~a~ ~~_ ota5oan • Timed dosing panels available. • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cyde controls. • Sealed Qwik-Box available for outdoor installations. See FM1420. • Over 130°F (54°C) special quotation required. 151t15211~3 Series t511152N53 MODELS Conhnl Selection Model Yolk-Ph Mode Amps Sim x Du x N151 115 1 Non 6.0 1 - 2 or 3 BN151 115 1 Auto 6.0 Included 2 a 3 E151 230 1 Nan 3.2 1 2 or 3 BE151 230 1 Auto 3.2 Included 2 or 3 N152 115 1 Non 8.5 1 2 or 3 BN152 115 1 Auk 8.5 Included 2 or 3 E152 230 1 Nan 4.3 1 2 or 3 BE152 2~ 1 Auto 4.3 Included 2 or 3 N153 115 1 Non 10.5 1 2 ar 3 BN153 115 1 Auto 10.5 Included 2 or 3 E153 230 1 Non 5.3 1 2 or 3 BE153 230 1 Auto 5.3 Included 2 or 3 SSE' EC 6 01~ CUIDE TOTAL DYNAMIC HEAD/FLOW PER MINUTE EFFLUENT AND DEWATERING MODEL 151 152 153 Feet Meters Gal. Liters Gal. titers Gal. Liters 5 1.5 50 189 69 261 77 291 10 3.0 45 170 61 231 70 265 15 4.6 38 144 53 201 61 231 20 6.1 29 110 44 167 52 197 25 7.6 16 61 34 129 42 159 30 9.1 - - 23 87 33 125 35 10.7 - - - - 22 85 40 t22 - - - - 11 42 Shut-off Head: 30 ft (9.1 m) 38 ft (t t.fim) 44 ft (13.4m) 1 I I 1111A6 I 1. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. 2. See FM0712 for coned model of Electrical Alternator E-Pak. 3. Variable level control switch 10-0743 used as a control activator, speafy duplex (3) or (4) float system. A CAUTION „ ;t i;? «tta. ,.:; c .,arfr~~s; ;~ ctactaa ae~~icas and srarr:i~ shau. ~ ~e dcn~ i~ a qua e' ,.w•: ', ~.: °i°. 4 and sa ... ra„~ s, : sid ~~ fei?~;=~eo i<tc ,. .....it 2 ' tt. t .. ,r; r„ a. i ~~ :.. _, . =t2cfr~cat lac (if ~i ~,~,,; f €~e :~a cr,_S aGtety ana r;^.t (~~ YN.; 415n6 stcz444 Models 152 153 3716 "Easy assembly" (pump & discharge pipe not incgrded.) ._._ _ ~ .. ~. F~`"3D ~~~~~ ~g6~;L • Reduces potential clogging by debris. • Replaces rodks or bricks under the pump. Made of durable, noncorrosive ABS. Raises pump 2" off bottom of basin. s Provides the ability to raise intake by adding setttions of 1'/z" or 2" PVC piping. Attaches securely to pump. Accommodates sump, dewatering and effluent applications. NOTE: Make sure float is free from obstruction. safety factor is engineered into the design of every Zoeller pump. For unusual conditions a reserve ©Copyright 2008 Zoeller Co. All rights reserved. POWTS OWNSR'S MANQALAi±@ MAMA PLAN . FILE INhOR1NLATIOAT Oo+aa ,6E c Pexnni~t fl - - . DESIGN PARAME'!'LRS - . Nr~berofBedrooras I p I+TA Nu~oabe€cfCam~ac3st NA ~ {}~ . Deslgufbw(pe~5},edxL3# GOO ~~- ~ ,~ Irtliu Qualify (NAIL) A~e'+ ~ t~-d~ diease (POG) da BiolO Dmn d~(IiOD ~ 30 ~, - . ~ s) a~ Tdd Sum Solids (TSSj 52?AmpfL - 5.250 Prdi~tedEifln~Qadhjr Q Irl~-A* Hiochanical 5 30 at~L ?owl S~dod Solids tTSSD 5 ~ ~ T~ :aD~ornt ~ ~Q dV100m1 _ MaF.@hi~Partitde Sixc 118.indt #Wasbewater Fbar VaOa and ~ {Otltertlmt bodi+ovnt bored) ** VaT,testypicallion~noo-oo~mec~ciatwer and septic lank . ***Ya~ . -' yot ~ - SYSTEM ~'ICAITQIYS ' Tao~C~ t/iESE~. Lo,~c, ~ PiA F.BlnentF~er Z.v Ec t7 PIA E>ihreat Prlter Model - oo C~ AT1! . 1`~uic So C~ NA •. . ~/ESE.c LorG.: ~ 1~IA ts! tt7L C1PIA _ Maad .. S.? ... p NA . . PreU~ ~ PIA p Sind Filter ~ D Pew FDler © MCI n ^ Wettaad Q Disu~actioa iuarirec - . II Odt~x: l~dd: mss) . Q (l~tY) t7 (P) ~ D !7 n8tet: CI +dr Dodd LSymgl tgglhlQie~fe[ SoD ~ RateArea IiCq I»fi>t~ive SndaoelChamber~Sl A patina - , $_ ivGnimtimN~bexa€. C1 R~ ntia all GIs aa~t oomplj- ~ WI Adm. Code t~0i~N84 aid be ii~d perms sud kEters. - p "Wisooiisiu At~rade Sort Abaocptioa Syrsbeaa, sttiog at Goion tc~rarse etat. tsytn p "Wisooasua Mamd Sa'1 Absorptioa System: Siting. Desi~ dt C~traaion ' taavrs~, J G and F.I'. Tex. Pablicdion IS22 - . EI tifP~reswre Netvrodcs ~r Se~cl3mk-Sod Absarptian S}rstems" F~ 9 ! _ 17'~>;ti+~.~A~!P~aad8eda'. RJ Utis-ASAE~3-?7aod'DesigRA~mI- f~iiiafe Wsn~ratcrTrealmea[ aad Disposal b~au5'`. Et+A 625/1-~-0I2 Ocx~ober 1980 - . ~ SBD -11/0{5~7D-P (R.f~'99) "At-C1Cade Compmwt I-d~aral ITsng Pressure p {,~..-- ~{.7V`'7~-P(R.6199)'gn Car+oiamdAb®orptroaC~o~l' p ~ -10y0S-P ~ALO1pI) Ya C~roand Sar1 Absocptiaa G~omposrd~.Marw~' Yerrion Z0 Q S8'D-10G2id" t~~'I ~ ~ - p ~- iE1656~~ (1rL6N9j"Split ~edR~aa~gSaadl~Sy~,ean P p SBD -105TH-P (R.b199j~undC' ~'S8D -101-~ (I~L4i101)'~ulanad ~ompoaart b~da~aP' Yew 2A - g SBD -14S9S F(R~99jeFassSeodF~er~omp~ent" . t'] SflD -1t1b557~-P(R6J!99ij`ctDisposat~ar~". _ - - C] SBD - iE13'73-P (R 6199] "Pae Dis~ation (~ponast ~' S8D -10706-P (I~LflIIDI) ~Ptessnro Dis>z~ion Qomponent 1Naa®t" Versiaa Z.0 ~ Oompo~drtMmualfocMu~a t~itc Wt U~ls .. u~ *tirrvvavt+a titnwtrrinvtnun_ e~rrtanTrrp a.~sawas. coad~tioa:of s - At /east - ~~ ~^~ O months 3 _ s 3 . a~os>s~ s : - ~Nheacoiobined aildsa>na Qftanicv~o>nm6~ s Atlarstoooc ~1.moc~s s - - ' 3 Chart dl~t filter Al least oaoe asodhs ~ s -- - - - . controls k alarm At feast oaoe O monu~s - s). ©xA Flnshh~lsatd test __~:: - ... At~astopoc. -.. moa$s 3.tR!- s O NA._ . .._ Valves-:.. _ . Atleastaooe, _. - ~ months _ [~ _ s O .NA ~ - . Othcr: ~~~~ ~ Atleastonce _ [1 months © ._ s ,_ O PIA . . START 1DP for new eonsirodioa,~ puocio use oaf the Pt~S t~toelc t ta,i~(s} for the pi~.~ a~ products or other ~paiads that aiay impede tie t gncess aadlar damage the ~spasai adt(s~ If bit eouoeas ~e defied hav~a the aon~s the . teak(s) raao~Mect by a aeprage savic3ng~opera~arprior[o'use. Systcm tit mA tali not ooarr nd~ t~ eu~tio~s t~ S~omoa at the OPERA1iON The p~Y owaer is~apoasbie roc 9~e operafios and efthePOWTS and mbt~ion ~mq~ed repoE~. TLc 9 aiadgnsblyafthest~a~la~oct ffietmdye~fy~oarPOW lS. The bfwater-~iag apaedalm~w~paDeApt~dfia~-titevo~Ahaotheix~eaw~teftamw~dc eoftendt~, iroo ragowad ~ char tSetrttetert dw3oea ttnd tttaias maid ba rood ~ tlt~ gtatod a>dave vvl' poas~la. I+to~ >h~ does Hot iHdade T , This sysbtm is det~ed b Ike doaae.:fic ttte afibod besets gzases aad oc'i:, ~h pacts aad aood~. bonesti aad Food, solids sacb as those proaabddb~r a gacba~e disposal thooid be miaitaitod. Ta~ettitnue is the Daly . paper that shaaid be rged~ the sysum. Otl~eraosaiiod~rad~te iteau mchas baby >aa~poos,, saaitaty Hapiuot owWoms, c~eette b~ dental iio~, aHd eateos sHaLc stroatd aot eater the aysteaa. Chi t~ as pettote.~ p paiai. ~,.pmidd~, aat~iotics, solveWd. etG., sho~old~otbe 8ushod iab me syt~ as hoy an ~ieasty ~ Pt3WT5 ~d~d~iolom8~~i . 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Exposed opes~gs gceata~ tt~auti~iacbetf in shaft be aaattai adth as ~Ctive todoag device m pon~entaaddental ar sm~ociaed entry iata thataalc W hea the oo~abiaatioa of:toc~e aed sew is a~ tttak r~aoeedc oaat~d (I/3) ar awe of tria tai c tIw ~ coate~s aCWe talc sira6 toa HHaoMed ih- s Sept~e Setvicte~ Opa~rcarddi~od afii~ soooalanoe w~ t,'tatpler]!~ttl3, Wisooasat Adamnisdativt: G1ode. 'TheaatktShatsl sta~i~e~spectadandc~eaaedia~Hmxxreaa~aocanmtl~edt~oiidsaooo~du~las- sptioas,-pa~oas a~eb 6a ~atlde to H sD1•ids ~ the tic. Fs'ttar deaetgg msY ire Y at ~etoae fmgpp~tS da~sl~ed ~lLenHiCieaen0esc~e~toloemffieajst~ cpe~m& Taaics t3ompaamit ~~ --• atust oc>adn a.lestof ~t etearicat ccpdpoaxatt sn~lEaspanq~ a~ and floats. A venal chxtm~ be maw ~` p~, arbr+olom secx~gr iev3oes and cthr ~dwet+e aod~e bd~t7 8~. 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' p _AarepLoea~ta~easaataa~able~etosd6~dEaa~Parso~HflevsatiaosB~cdggadviooasit~"OWT3leciao~oflya holdiag~tapgrba~edata5atrt~tsaephosfl,SSfle~P0~1TS. 1LesNeb~aotbesa~nhotlediQiimt~rsrepLoemeatac~ea.I~otS~safBo;P~'~3as~ads~~vs amtbspar~oesedb bc~0eas~terepLoe~aotsrea. ~fi~rdiq+Loeaoaotoneais sib shol~ta~naayba ~Ealfed as shmtn~o~tiusq~Loaflre SfledPONS. Ma.aaaaatgaamsoSab~o~aaua~gba:+aoao~a~cleai~pdosremo~at af~rsbim~tat~si~a~ira . B~aoo~ian~afsar3<s~laesm~tcoaa~ywi~flaa~iaine~etatihettha~ Ewa S~ P'a~ A1~iD Orr86d<3>fl~d~t~NP TApRS I~AY aQfl~i Ii18AL GASS~BS At~Bl~NT o~re~t nor~oae~s~ra+~r~ ~o~r~euaer~aNx na~t~as~~co~a~s~~o~~ra~~ut~eognz os m~os~a Pow~rsn~srA~ Phnue 7is 7.~ - .?L6 Phone ~ oov~rs ~rsHOrsiaa Powrs S C7.? - LG ' A ~r .ro/ ZO.vr•~i OFF/GF'- rs 38G - yd 80 Page 9 ~ oi~ The i~lersaliorse~icigs~lic#at~ics is~etb~s~e and Cat codes ~bou8i~ the ~1~i1edS~alas~ereis a Z,~M+of~~at~atdisi~sHpii6e,butntoet div. ~c~ does iheiregt~en~-af~ abonid~+dee~~e~dMten~e Ze~~sd. 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T ~t sib send e~ddtffg6 r aeb' ~„ -' :: ,.. ~ad- ~~ ~e t wa aS4 x 1 "I N as ~ -„~} ate, nd d a: rsimretuw- P~ t p0i6,~ Apr, ~ or ~ north am~w, aa+d ta~t;aliors and dt ~ "~' ;n ' at!! 1rd'i~ ~ '~ , , , i ~1ban+~an Yom' A ~Y ~ wed Ix Mr~oRrdsiY t~ s. ! 5.oi ('t~ ~• Des ~'O' ~t~, wE~taa, 5'SC3, rx~~~ ~t#"k~t t$,~+tt't'~if~4E'3~ ~~"TE a ++t* ~Iatatc~ d• N arGSl~ X38 8~H AM'E~EtD ~ ~ ~ ~ Tnwrt ~ ~fos~ iht~ S4oa~- tZV.~ra+s.w~~ - _.._ . . uae: ~idrnmA r Numt~ of b~ -____~ Cis ds~9-«ed fk~"~- - ~ ~w-ra~a~o~r ~ ~~ ~ aub~a or elf - tiescrrt~r: F1oao ~+ e~w+d~ian. it e~ .~r.-~--~---#° ! i~'~~ C~'VER Tel.. ~y o 101.F10`. iii a tt14 {e~#1). ~I~ ~Ni~OfdMOU~~ ~ . _~ ...__ rewr - !T-S I IYTirilRfii'IR'RJ~ ~. ~ 3AYR 3/2 816 lOYR "~ 3 x,6-28 7.'s"Y~I.4/4 ~ 1 C S'S~C €'~t Cs~ IF ~,~t 0~5 ~ ~ _ ~ _ ... 0.2 Cl.B t3oeiE~ +~ ~ ~ Qround ~trv. 'g9.50 It. 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R~ li A~rpti~ft~ . . , ~ p(t Groun 51L 1 C G~, TJ~!'i L"W ~~ ~.:4 t1.15 Ice ~ ~ ~ ~.# 4.6 ,,~. rry~ tt~~~~ -. ~.-f L .7~7V"~ it)YFtdd/J~~'j N~3WE 9L ~+ xM t{''~ t -.~ p Q~+~ WV ~;, 21y»24 ~ ~ GRL~S 7.~t 3/4 ~ ~ b C} 1~.~ too r.~rtt ~ G~k. o lK bpi _. ..___ . _.~....~ 4 ~-3z ~.~'t 4!6 . ,~ ~ ~5 ~ ao - ~,,~ ass ~ sa mom. ~liurrvtit « BODSa ~? a 220 .. mrzti'CS~i >30 <'{5f1 a-C14- ~'~: i~ ana eg~al ~~' ~` prnridax:~ ~. Xf vou~ ~ a strvsr~s a~ i~te~~ ad 601 Z6b-;i Y5E oir'» ~~ aecd ~ is ea ~ !~. P ~ ~ eeu7.d-sa-~s~r+~.+ ~wi.c~e0~.~+~f ~m:MyFax - Kimberly Marsh To:Pelke Plumbing (17156725267) . ~.,= CUUUf~1 u~ ! oHM CYOS 18:41 03129/09GMT-04 Pg OS-07 Ntl,l ~o, ~~~ rcv lazes _. ._ ~,,, ~.. r _ _. _~ ........__. _. _.. _.. FUFt~ST R1i~~Ey pR~~T1~~ ::~~ ~ N p~.Q~T Pi.~ld FC~t. tt)T #'~ S~ _.. ~ gw~afesot ~-- w9x(+-1iIJ.iO~M ~~TtFtf~90tT~iSt R t~F O SYS~ q~py~($}?2731fi Mgt'p~ll S?+ ~~ima .. ~Iar~ tvcattaet~soa. sao~st ~ra~s ~aa~rrwaFi.artsls "rio~c N-fir. ~~ ~~ i~ wa t 1 ~~ J 1 j #~ 1 s ( f 1 tt !' t 1 1 1 t ti b a ~~ ... _ --... _ .__. _...~....... t~lif-I~r1ik28~~iI ~trs~~ PAS 1i~~CR#8ED A61D ~C. t ~~ /IY1 ~AVpa LeHam P1 ~ OF ~ ~ rte, PELKE PLUMBING Fax:715-672-5267 Apr 14 '10 10:33 P. 02 ST. C.ItOI~L COUI~TTX SEP'i`~C TANZC, MA,T~iTE~1ANCE AGREEMENT AND fJWNBRSHIP CERTik ICATION FARM (h~vnerlBuyer l~a~iliz~g A,dd~tess Property Address °505 -'~ 5 (U ~ • ` f-~V~P2 V ~. W ~ ISOYI 1931 ~;~ (Verification regtured from Planning ~ Zoning Department for new construction.) ~~ ~\ 1 ,~ City/State ~~ 1 1St Yl W ~ __~ Parcel T.deutification Number (~0 ~ - ~ b2 ~ - ~ OJ 10 ~T DES I N Property Location ~~U '/. , ~ ~ '/d ,Sec. ~, T ~N R ~ J W, Town of C,QC~1~_ Subdivisia~ ~ , Lot # ~. Ccrt~ed Survey Map # Voluxtze , 22 ~, P'age # 53 -? (n Wurranty Deed # Spec ba~use yes n~o volume _ ,Page # l:,ot sines idermfiable yes uo SY~~EM MAIN~EN'ANCE ANA OWNER CERTIFICATION Improper use and mui~natcce of your septic system could result in its pue faihue to baaodle wastes- Proper unaimena~nee consists of gu~igg out the septic tank every three years or savaer, if needed, by a licen.ed pumper. What you put iota the systecc- ran affect the function of the septic tank as a heatment stage in the waste disposal sysEcm. Owner maintec~ance trspomsibilities are specified is ~Cotffit. 83.52(1) sad in Chapter 12 - St (:roix County Sanitazy Ordinance. T1ie owner agt+ees ~ submit to St. Croix Canary Phuming & Zoning Depax~tmer<t a certification force, signed ~y the owner and by a coaster plumber, ]Y~ Plumber, crskitcted pluaaber or a licensed pumper verifyuag that (i) the on site wastewater disposal system is in P operating condition stndlor (Z) afirx inspection and pumping {if ta+cessary), the septic tank is teas rhea 1!3 fnii of sludge. Uwe, the un~cs have read the above requirements and agxee ~oo tnaintaun the private sewage disposal system with the standards s~ forth, herein, as set by ~ Department of Commerce and the Deparment of Natures Resources, State of Wisconsin- Certificationstating that your septic system has been maintained must be eompletect aacl retiuxued to the St t~roix Cocmty Platuaimg & Zoning DeparftneArt within 30 days of tbs tbzee year expiration date. Drove certify that ail statements on thin form are tree to the best of mylaur knowledge. Uwe am+axe the owner(s) of the pxope~rty deacn'bed abavt, by virtue of a waAanty deed recorded in Register of Deeds Office. Numbe b xoopas ~~ ~~~.._ ATURE C1F APPLICANT(S) ~~~~~ DA'Z'E **''Asty information that is misrepresented may result fn the sanitary permit being revoked by the Planning & 7foning Department. *'~~ include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if rafwranrr ie rr~nrtP in thy. warranty drexl State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number ~~ Document Name THIS DEED, made between Forest Ridge Properties LLC a Wisconsin limited liability companv ("Grantor," whether one or more), and Kimberly J. Marsh ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): That part of the Northwest Quarter of the Northeast Quarter (NW 1/4 of the NE 114) of Section 10, Township 28 North, Range 15 West, described as follows: Lot 1 of Certified Survey Map recorded in Volume 22 of Certified Survey Maps on page 5376 as Document No. 847368, St. Croix County, Wisconsin Recording Area Name and Retum Address This deed is given in fulfillment of a Land Contract by and between the parties 004-1021-30-100 dated Apri116, 2009 and recorded April 20, 2009 as Document No. 893600. Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encum~br~anj ces except: easements, restrictions and restrictions, if any, of record. Dated ~ ~Z~'1 to Properties, ~ /X~ Mangelsen, ~ (SEAL) (SEAL) * AUTHENTICATION Signature(s) Forest Ridge Properties, LLC, a Wisconsin limited liability companv, by Rodney A. Mangelsen member authenticated on . *Kristina Ogland TITLE; MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Kristine Ogland, Estreen & Ogland 304 Locust Street. Hudson, WI 54016 ACKNOWLEDGMENT STATE OF ~Ayrt~7G"Yt- t~-~ ) ss. ~fit~ iX COUNTY ) Personally came before me on ~ ~~ ~~~ the above-named - (•LC. to me known to be the person(s)' ho executed the foregoing ent and ackngw~elged the same. ~~~.r," I .{~ , {~ yK 44 LU"1'.~" Yz~ * t, ~ ~ Notary Public, State of ~ My Commission (is permanent) (expires: (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ®2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 * Type name below signatures. INFO•PROTM Legal Forms 800-655-2021 www.infoproforms.com Fm:MyFax - Kimberly Marsh To:Pelke Plumbing (17156725267) LLD 1.: V17.LJ 1"13A fiV ~)VV `lVVV ~t~ - '~ Rte srr. ct~tmn"r ~ ~ ~ ~~~ ~ . ~ ~~RT~~"~F.I3 SURVEY vo~v~E ~~ ~~~~~ ~~Tt4i.EEN ~I. ~aLSH ~~cTSt~c~ e~ ~~~ ~~ . cl:aax ~c~. , ~z t~~:~1~ ~~ ~E~ p3,~7'9/Zr~07 12 : 3~bPt~ CF.t~iIFl~tl StJRYEY FtkP EtEG !`EF :. 13.00 C€lpv FEE: 3.00 PA+~E ~ ~ - ~,~A~r~~a ~N ~e~~ r~a~x~'~'~y~~/ra +~~ t~~l7~cE y!r~s~y~-~y~°~~~ ~ /~. 'i `'iJ~i'~~~~ ~L ~i.~ icy a~~~E~V ~'V'~~ 1 Y r ~l~ ~it~?ai`~ ~~~ rr~ CE1tt1ER wdN'pt ~ 31~ REW1t i PAY Cs~ Y~~f. ~'~ .. ,,,,. xw ~. .,... ...:,..W .~. ~........ '~ .,...w. ~- :~e''° ' :'~ ]'3,t1r~°' Af89'~t2~iB"Vit CT` ~ ~ xx c,n _ ~, .. _ X2`4#" t'S~.t3? . x32 ... _ _ _ _ _ _.., ~ 1`- ...... _ .. - ~ .... "~ 9bM'~ 414:tYlt'b`.4Y~as ~ . as 3K; lM .{ " ~ t Ad6 ~~. 18:41 03/29109GMT-04 Pg 07-07 JL 4Y~.ti. VV LVt~ Ll~V `4GN '~ 8 ~. , ~ ~ 1CS.Y.T acte+~ `-- ~ ~~, r-a--r•} ~y iry ~ ~ ~ fry, .,"~y ~ x.137 ~eats~ /y{~^+ s ~i) n ~ ~. u. ~' - L ~ y ~~W~ ~ $ t 1f i 0. ~ L f irWY f +4a ~ e•s # +••d` ~. i.ir"g Si. itr~.CttS e. 1, ~. ere S?5 agx~rr~~a a e~ 45 ttelrve•a~ .r_.~3' s:'..+!*, ¢p ,.., sdY:;3.. ~,,., ~:._sg~ sr. :"a'+<1, a~.,':,.-..~s7 4 ~' #,'i'n@l$ ~{9{2~. Y^iF~ir~ KY5~47~ sY'.~F...::.~«,Yy....~'#' ~st£- SF,K'.~t J ?f...:..'F~ ~ 5, Q ~F•tr~.~J1~.'.:EC~f7 4SJ'~`~.'-4~id AIL t ~.P+yi'~t:~?Y a 1~.. P ~ ..... .. v. f _~ >4 ~ .' b~.s ~ 1~ •• 64: v~ ~+~s. ice.. ~{s1 z yO F > ~T ~ 's kae'R's..,, d. ~~t `@ at' _ ~. '~ .. i .•.'t ';y ci4 ` ; 1 4 llllll 111i1111111111111111111i1 lilt 11111111111111 * 8 9 444 5 7 4 5 4~~~~~ BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 05/01(2009 11:0(lAM ASSIGNMENT EXfHPi ~- REC FEE: 19.00 PAGES: 5 R~ETt7Ra1rV T0: Tf'145~~i,,~,-1~i i~IQ~s~~ POB i3aldwi WI 54002 ~~QQ``~~ LD ~ Sf 7`t~~sdr~, l,t/f 5~vi ~~~ i ~ ~., a'' ,.f~~~l~.cl G~.~ PII3 : 004-1021-30-I00 Space Abave is far Recording Information ~C~, ASSIGNMENT OF VENDOR'S INTEREST IN LAND CONTRACT Loan No. 7609379100 This assignment, dated and effective , is between Forest Ridge Properties LLC. Peter J Gartmann, Ann K Gartmann1 Rodney A ManQelsen, and Tamrha V Mangelsen ("Borrowers") whose address is 358 85th Ave, Clayton Wisconsin 54004-3208 and AgStar Financial Services, FLCA ("Lender"} whose address is 1921 Premier Dr, Mankato, Minnesota 56001 For value received, Borrowers grant, assign and transfer to Lender, its successors and assigns, the vendor's interest in a contract dated ~~,P,-; i ~ ~?np~q_____ ,made by Forest Ridge Properties LLC, a WI Limited Usability Company as Vendor to Kimberly J Marsh, a singleperson as Vendee, and recorded in the office of the Register of DeedslCounty Recorder/Registrar of Titles in the County of St Croix State of Wisconsin , in Book -Volume - Liber of , on Page , or Document, Microfilm, or other Identifying No. 893600 ,for the sale and conveyance of a tract of land located in said County and State, described as follows: That part of the Northwest Quarter of the Northeast Quarter (NW1/4 of the NE1/4} of Section 10, Township 28 North, Range 15 West, described as follows: Lot 1 of Certified Survey Map recorded in Volume 22 of Certified Survey Maps on page 5376 as Document No. 847368, St Croix County Wisconsin. (continue legal description on page two if necessary) This instrument was drafted by: Stacy Proudlock (CP), AgStar Financial Services 540 Baldwin Plaza Dr Baldwin, W) 54002 DiS7155 (9/2005} 1 of 5 /P' i L-J bt d9l 1 1 1 1 \ 1 1 I /~ 1 B 1 I 1 1 I I I I I 1 I >? ~ 1 1 I I b m rn Z ri .rs b h ti '7 b A 4 =P bA bil bR by b a § , § $ ` }~ ac b N 1 t2l dYM Q rl rS 7 bZL T bZ O ~ ~ b[ ~ ~ ~ bZ A ~ b ~P b ^ (vim b ~ rc ac „ _-__ b ____ $8 1-6 SZl FB 1S rZt 4 F N - ~i._ , ._.:r ~........~....r.T #2477 ~'r~~JR .7VIL CVHLUHII ~~ Page 1 of 3 Department of Commerce in accordan Comm 85, w ,. Division of Safety and Buildings ~~ eo Tech Soil & Site Evaluation, LLC Attach complete site plan on paper not less thy' nches i .Plan must ~~~ C u ~'~ ~ St. Croix include, but not limited to: vertical and horizon feren BM), directi and pp.. percent slope, scale or dimensions, north arro nd cation and distance to eares~c~~ IX C~UNN Please print all information. PLANNING Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ Z Property Owner Property Location GARTMANN, PETE Govt. Lot NW1/4, 1/4, S10, T28N, R15W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 358 85TH AVENUE 1 NA City State Zi Phone Number ~ City ~ Village ~ Town Nearest Road CLAYTON WI 54004 715.562.0330 Cady 50TH AVENUE New Construction Use: ~ Residential /Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement ^ Public or commercial -Describe: NA Parent material LOESS OVER TILL Flood plain elevation, if applicable NA ft. General comments Site is suitable for a mound component. system elevation =101.00'. Maximum basal SLR = 0.4 (eff #1). and recommendations: ^ 1 9 ^ Boring Borin # ®Pit Ground surface elev. 101.60 ft. Depth to limiting factor 28 '/ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GP D/ft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10YR 3/2 NONE SIL 1 M SBK DSH CS 2F 0.4 0.6 2 8-16 10YR 4/3 NONE SIL 1 C SBK DH GS 1F 0.4 0.6 3 16-28 7.5YR 4/4 NONE LFS 0 SG DH GS 1F 0,5 1.0 4 28-33 10YR 4/6 C1D lOYR 5/3 7.5YR 5/8 GRSL 0 M DH -- -- 0.2 0.6 ~~ 2 ^ Boring Boring # ,,~ ® Pit Ground surface elev. 99.50 ft. Depth to limiting factor 26 In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GP D/ftZ in. Munsell Qu. Sz, Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10YR 2/2 NONE SIL 1 C GR DSH CW 2F 0.4 0.6 2 9-18 lOYR 3-4/3 NONE SIL 1 M SBK DH GS 1F 0.4 0.6 3 18-26 7.5YR 3-4/4 NONE LFS 0 SG DH GS 1F 0.5 1.0 4 26-35 7.5YR 4/6 C1D lOYR 5/3 7.5YR 5/8 GRSL 0 M DH -- -- 0.2 0.5 a 'tom... * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD _30 m and TSS < 30 mg/L CST Name (Please Print) Signature: ; /~ CST Number William J. Bergh ' - / 227819 Address Geo Tech Soil & Site Evaluation, LLC Date Eval io cted Telephone Number 4255 N Prairie View Road, Suite 2 Chippewa Falls, WI 54729 8/21/200 715-723-5555 ' Property Owner GARTMANN, PETE Parcel ID # Page 2 of 3 3 ^ Boring Boring # ®pit Ground surface elev. 96.20 ft. Depth to limiting factor 24 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/frz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10YR 2/2 NONE SIL 1 C GR DSH CW 2F 0.4 0.6 2 10-18 lOYR 4/3 NONE SIL 1 M SBK DH GS 1F 0.4 0.6 3 18-24 7.5YR 3/4 NONE GRLFS 0 SG DH GS -- 0.5 1.0 4 24-32 7.5YR 4/6 C1D lOYR 5/3 7.5YR 5/8 GRFSL 0 M DH -- -- 0.2 0.5 .-, __.. ^ Boring Boring # pit Ground surface elev. ft. Depth to limiting factor in. ^ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring # ^ Boring pit Ground surface elev. ft. Depth to limiting factor in. ^ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 <150 mg/L * Effluent #2 = 80D5 < 30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) Gf0 TECh SOiI & SItE EvalUatiOn, LLC • , N W E S SCALE 0 20 40 (UNLESS SHOWN OTHERWISE) WILLIAM J. BERGH WISCONSIN CERTIFIED SOILTESTER DESIGNER OF ENGINEERING SYSTEMS CUSTOMER ID 227819 BUILDING SEWER MUST COMPLY WITH COMM 82.30 WAC (11)(C) LOCATION OF WELL MUST COMPLY WITH WDNR CHS. NR 871 8 872 BENCHMARK ELEVATION =100.0' - BASE OF EITHER STAKE e LOCATION OF SOIL BORING(S) ® LOCATION OF SOIL PIT(S) tk NO APPARENT COMM 83.43 SETBACKS ® DESCRIBED LOCATION OF LOT LINE ® LOCATION OFRIGHT-OF-WAY ®CENTERLINE OF DESCRIBED ROAD FOREST RIDGE PROPERTIES PLOT PLAN FOR LOT #1 (yy) (100) (101) (9e) t r t t ~ ~ ~ 1 1 I 1 #3 (98.20) 135' AVAILABLE LENGTH NWNE-10-28.15W CADY TOWNSHIP ST. CROIX COUNTY, WI PARCEL DESCRIBED AS 10 AC. 500' TO 50TH I AVENUE SURVEY MARKER PAGE 3 OF 3 \~ Wisconsin Departrnent of commerce ~`~ ~~ SOIL EVALUATION REPORT Division of Safely and Buildings `~~ ]~' „_ Page . 1 of 3 m awvruan [n ~. aa, vns. warn. a.vae St. CI'O1X Attach complete Site plan on paper not less th x 11 inches in size Plan must inGude, but not Nrnited #o: vertical and horizontal refer . s t (BM), direction and Paroel I.D. p ~ \ percent slope, scale or dimensions, north arrow, an pq pa Rosrko~+earest cad. Y C~J ' Please print ell info CC 1 etion. Re ewes by _ _ __ Date Personal information you provide may be used for second pu ri La .04 (1) )). /} G (~ ~/~ CJ~ Property Owner Property L lion ® O Pete Gartman- Forest Ridge Props ies ST. CROIX C Lot NW 1/4 NE 1/4 S 10 T 28 N R 15 E (or) W Property Owner's Mailing Address Lot # lock # Sutxl. Name or C~A# 2/ 358 85th Av Gartman ~ / ~3 76 City State zip Code Phone Number ity ~ V Nags ^ own Nearest R ~ S -~ Clayton WI 54004 ( ) 50th Avenue New Construction Use Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 FteplacemeM Q Public or commercial -Describe: Parent mat@rial Loess over till Flood Plain elevationrf applicable pT~ General cx~mrnents ~ „~, q,ti ~ ~ o.~ ~ ~ .~, r-- ~.Q yI,U CG~'i-~32L~~ and recommendations' ~°.~/ R D Boring # ~ Boring pit Ground surface elev. 98.90 ft. Depth to limiting factor X41 in. Soil ic~ition Rate Horizon Depth Dominant Colo Redox Description Texture Structure Consistence Boundary Roots GP D/Pf in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 •Eff#2 1 0-8 10yr4/2 - sil 2msbk mfi' as 2f .6 .8 2 8-18 1 5/3 - sil 2msbk ~' cw if .6 .8 3 18-41 7.Syr5/6 - is Osg ml _ _ .7 1.6 2 Ong # ~ Boring 98.90 25 pit Ground surface elev. ,,,,ft. Depth to limiting factor ~, in. Soil Rate Horizon Depth Dominant Color Redox Description Texture Stnxture Consistence Boundary Roots GP D/f~ in. Mansell @u. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 1 0-9 10yr4/2 - sil 2msbk mfr as 2f .6 .8 2 9-25 1 5/3 - sil 2msbk mfr cw 1 f .6 .8 3 25-46 "~.Syr4/6 - lfs Osg ml - _ .5 1.0 * Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 150 mg1L `Effluent #2 = BOD < 30 mglL and TSS < 30 mglL CST Name (Pl~se Print) _ _ Signature CST Number Thomas C Nelson `~- 2273$7 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, WI 4/24/06 715-246-2454 GPD +•y _- w Pete Gartman- Forest Ridge Pending Properly Owner . Parcel ID # Page of _ 3 ~n9 Boring # ®Pit Ground surface elev. 98.20 ft. Depth to limiting factor 33 in• Shc tieation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/f~ in, Mansell Qu. Sz. Cont.. Color Gr. Sz. Sh. 'Eff#1 'S~ ._ 1 0-9 10yr4/2 - sil 2msbk mfr as 2f .6 .8 2 9-21 1 5/3 - sil 2msbk mfr cw 1 f .6 .8 3 21-33 '7,gyr4/6 - is Osg ml cw _ .7 1.6 4 33-46 7.Syr4/6 fLf5yr5/8 vfs Osg ml - - .4 .6 Bonng # Boring. Pit Grouhd surface elev. it. Depth to limiting factor In. Soil ic~tion Rate Horizon Depth Dominant Co Redox.Description Texture Structure Consistence Boundary Roots GP D/ft= in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 ~~ # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/F~ in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 *Eff#2 * Effluent #1 = BADS > 30 < 220 mglL and TSS >30 < 150 mglL 'Effluent #2 = GODS < 30 mglL and TSS < 30 mglL T'he Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access. services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. asn.s~3orreu (te:mroo> . ,~ ~ ` J 1 poa Pete Gartman Lot 1 ~~~~ Scale 1" = BM1 Top a BM2 Top a B1 98.90' B2 98.80' B3 98.20' Thomas C Nelson ~. 227387 SE Lot corner M ;~ .: . ~`. v . µ ~ i iilill i~'" "!ii !~!l~illl~li !IN Iii RECEIVED 847368 Np~ ~ ~ ~ YOL 2.-PAGE g3~6 KATHLEEN H, 1iALSH REGISTER OF DEEDS ST. CROIX CO., WI >~1: Ct~ ~~ RECEIVED FOR RECORD >~tJRVEYOR'S 03!29/2007 12 : 30PM CERTIFIED SURVEY MAP REC FEE: 13.00 COPY FEE: 3.00 CERTIFIED SURVEY MAP NO. s376 PAGES: 2 VOLUME 22 PAGE s376 LOCATED IN THE NORTHWEST 1/4 OF THE NORTHEAST 1/4, SECTION 10, TOWNSHIP 28 NORTH, RANGE 15 WEST, TOWN OF CADY, ST. CROIX COUNTY, WISCONSIN N NORTH t /~ CORNER r$ ~ SEC.tO, t28N. R1Sw FNp. CO. SURVEY NAq, ___ ~,~_ x __~ .._ z 3 ~ ss.oo ~ ~ off"' 3 a - LO, ~ =~ 440.9 v ~, ~ ~ tO.t2 tit ~ ~ 3 (mcl. o, s29,9' _ ~ ~ ~ 9.87 t W (not incl. ~_ n "e ~~~ 3 ~eMV •74 g Xi "/1,'~~~ J J. ~` of 2 uNp>a~rsu u-xos '-ter _ -"~ .. N89'S2~44"W 1329.87 t~~~. .-.. .:~ s NO ~~~', u .. `.VS ~ t~ J LEGEND t' GOVERNMENT CORNER (AS NOTEQ) • SET, 1" X 18" O.O. IRON PIPE 1NEIGFIING 1.502 165. PER UNEAL FOOT, "'-•--- EXISTING FENCE sal eoRINC locwnoN trteEr ~ aF s SCALE: 1 "=300' O' t?i0' X00' 600' Vol 22 Page 5376 4!r A uNpu-rrgu wins ~Gf~O, TE2lN, R1SMI ~/4" REOAR NORTH UN£ NW 1/4 - NE 1/4 50TH AVE. ~ .. ~ . . +~. ~1 +~ , ~ ~ ~ ~;~: ,.. , ~. :, CERTIFIED SURVEY VOLUME 22 , MAP NO. 537;, PAGE 5376 LOCATED IN THE NORTHWEST 1 /4 OF THE NORTHEAST 1 /4. SECTION 10, TOWNSHIP 28 NORTH, RANGE 15 WEST. TOWN OF CADY, ST. CROIX COUNTY, WISCONSIN L PETER J. GARTMANN, WISCONSIN REGISTERED LAND SURVEYOR. NEREBY CER't1FY; THAT I HAVE SURVEYED, pVIOED ANO MAPPED PART ~ THE NORTHWEST t/4 OF THE NORTHEAST t/s , SECTION t0, TOWNSHIP 28 NORTH, RANGE t5 WEST. TOWN OF CAGY, ST, CRgX COtNiTY, WISCONSIN, MORE PARTICULARLY DESCR18ED AS 6ECINNMIG AT THE NORTH t/4 CORNER OF SAS SECTION t0; THENCE 589'S2's4"E ALONG THE NORTH LINE OF TFiE NORTHEAST t/4 A DISTANCE OF 1329.67 FEET TO THE NE CORNER OF THE Nw 1/4 OF THE NE 1/4; THENCE SOO'28'37"w ALONG THE EAST LINE OF THE NW 1/4 OF TI1E NE t/4 A DISTANCE q" 1327.48 FEET; THENCE N89'49'S8"w ALONG THE SOUTH uNE OF THE NW 1/4 OF THE NE t/4 A DISTANCE ~ 1329.39 FEET; THENCE NOO'28'37"E ALONO THE WEST LINE OF THE NW t/4 OF THE NE t/4 A DISTANCE OF 1326.41 FEET; CONTAINING 1.764,319 SOUARE FEET (40.50 ACRES) MORE OR LESS. AND BENiC SUBJECT TO EXISTING EASEMENTS. THAT I HAVE MApE SUCH SURVEY, LAND DIVISION ANO MAP AT THE OIREC710N OF FOREST RIDGE PROPERTIES, LLC. 338 85TH AVE., CLAYTgY WISCONSIN. 54004. OWNER. THAT THIS MAP fS A CORRECT REPRESENTATION OF THE EXTERIOR 8OUNOARIES OF THE LAND SURVEYED AtVD THE SVBW1ASfON THEREOF MADE. THAT I HAVE .FULLY COMPLIED WITH THE PROVISIONS OF CHAPTER 236.34 OF THE WISCONSIN 5TATE STATUTES AND THE SU6gVISION REGULATIONS OF THE TOWN OF CAGY AI+~ THE COUNTY OF ST, CRgX IN SVRVEYINC, DIVIDING ANO MAPPING THE SAh~. OATEO ~IIS _ /Orb OAYAR' 2007 , PETER J.~12TMAf~pV R.L.TS. /2279 EACH PARCEL SHOWN ON THIS MAP IS SUBJECT TO STATE, COUNTY ANO TOWN LAWS, RULES ANO REGULATIONS "I,E., WETLANDS. MINIMUM LOT SIZE, ACCESS TO PARCEL, ETC" BEFORE PURCHASING OR DEVELOPING ANY PARCEL CONTACT THE ST. CROIX COUNTY ZONING OFFICE AND THE TOWN OF CAGY FOR ADVICE. gpPROVED !~lUM*188'~C~TM MAR 2 9 2O0Z g~~ ~bs .~~~ fir; Wis. ;sue 'f •.: .;4a~ `, . ....~t~ 7n sP+ y ~~ ~ `tSt1 ~a • . ` ~' sIIEt:T z of s 2of2 Vol 22 Page 5376